| NPI | 1619333788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA MARIE VAN DE WATER Owner 907-957-6597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AK 983) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2022-05-06 |